To get started, we will need you to provide us with detailed patient information.

Please print and complete a Patient Intake Form and a Patient History Form. Both are available in English and Spanish.

Please email completed forms to info@garmclinic.com

Assessment Quiz

The following quiz is designed to help you assess your general wellness and lifestyle choices.

Answer honestly and skip any questions which do not apply or with which you are uncomfortable

Name
Email
Phone
1.

Are you tired all of the time?

1 out of 16
2.

Are you constantly in pain?

2 out of 16
3.

Do you take multiple medications?

3 out of 16
4.

Is your belly getting larger?

4 out of 16
5.

Are you stiff and lack flexibility?

5 out of 16
6.

Do you have a chronic disease?

6 out of 16
7.

Do you have an unhealthy diet?

7 out of 16
8.

Do you have trouble sleeping?

8 out of 16
9.

Do you live with high levels of stress?

9 out of 16
10.

Have you had cancer?

10 out of 16
11.

Do you currently have cancer?

11 out of 16
12.

Are you an insulin-dependent diabetic?

12 out of 16
13.

Do you suffer from arthritis?

13 out of 16
14.

Would you like to look younger?

14 out of 16
15.

Do you want a healthier lifestyle?

15 out of 16
16.

Are you an athlete looking for an edge to help you continue to participate at an elite level and hopefully add years to your performance?

16 out of 16